AMA Transcript - AMA Vice President, Dr Stephen Parnis, 2SM Radio, 1 October 2014

JOHN LAWS: The first case of Ebola has been confirmed in the United States. The patient is believed to have been infected in Liberia and has been hospitalised in Texas. According to the World Health Organisation, the Ebola outbreak has infected over 6500 people across five West Africa countries, killing more than 3000 people; so almost half of the people who have been infected have died. It's the worst outbreak of Ebola in history. Joining us on the line is Australian Medical Association Vice President, Stephen Parnis.

Good morning Stephen Parnis, and thank you for your time.

STEPHEN PARNIS: Good morning John.

JOHN LAWS: Okay. Following the confirmed case of Ebola in the United States, are there concerns we'll see a confirmed case of Ebola here in Australia?

STEPHEN PARNIS: Well I think the - as the severity of the epidemic increases in Africa, the theoretical risk of someone being infected coming over on a plane to Australia does increase as well, but the risks still remain very, very low.

JOHN LAWS: How is it spread?

STEPHEN PARNIS: It's by body secretions. So, it's people's blood, vomit, bowel output; those sorts of things getting into contact with recipient's airway, or mouth, or mucosa - so their eye surfaces. This is how health workers or family members can be infected by it.

JOHN LAWS: Okay, and how does it affect people?

STEPHEN PARNIS: Well, the initial symptoms are very non-specific. They are fevers, they are feeling generally unwell, loss of appetite. But as things worsen, it can cause bleeding from a whole number of parts of the body and, as you pointed out in your introduction, as things stand, a majority of people who are infected will die from the disease.

JOHN LAWS: So - I hate to put it so bluntly, but - your blood vessels start to leak, do they?

STEPHEN PARNIS: They do, and often the reason is because, as part of an overwhelming infection, the clotting factors in your blood and the platelets get consumed and so you don't have anything left to provide a normal clotting system in your blood. So, it's a very serious viral illness. But I think one of the key things here is that some very basic measures and basic supportive health care can…control and reduce spread and give people the best chance of survival. That's really the key message out of this.

JOHN LAWS: How can you avoid it?

STEPHEN PARNIS: Well, the best way is if you don't need to go to these areas where it's epidemic, in West Africa, then don't go there. But if you are a health worker - and we've got some wonderful people who are dedicating themselves to trying to control this epidemic - appropriate protective clothing, masks, goggles, these are the things that are essential when you're treating people who are infected with Ebola.

JOHN LAWS: So it's pretty virulent?

STEPHEN PARNIS: It is. I think it needs to be put in context. It is not as infectious as say, influenza.

JOHN LAWS: Oh, really?

STEPHEN PARNIS: … That's exactly right. And what we don't want to see is mass panic coming out with this sort of thing. What we really should be focusing on is trying to control it at the source, which is West Africa. And that's why we're saying that we should be putting some serious expertise from Australia to support these countries which have a poorly-resourced health system at the best of times.

JOHN LAWS: Well, I agree with what you're saying, but apparently the Australian Government doesn't, because they say they're not going to send in health care workers to West Africa because there's no safe evacuation process in place.

STEPHEN PARNIS: Well, I compare that with what's happening in Syria at the moment. The Australian Government has very close links with other governments that are involved in that process and there are some things that the Australian Government can't do, but they negotiate and work with their partners to deal with that. In this case, there is no difference. The Australian Government should be working with the Americans, the British and other countries to...

JOHN LAWS:  Are they?

STEPHEN PARNIS: Well, if you believe what the Foreign Minister is saying, that we're waiting for the call from the World Health Organisation; I don't think that we're trying hard enough, to be blunt.

JOHN LAWS: No. Well, I don't either. Because it's a very dangerous thing, obviously, and it's very virulent, as we said earlier, and we should be doing everything that we can.

STEPHEN PARNIS: The Prime Minister talks about global events having an effect on Australian national security. I completely agree, and I think that this is a key example of that, and our action or inaction will be remembered.

JOHN LAWS: Yeah, well, I think we've got to do something. I mean, health care services on the ground are struggling to deal with the crisis as it is and, obviously, that would be fuelling the epidemic to a degree, wouldn't it?

STEPHEN PARNIS: Absolutely. And this is the reason why health authorities are predicting that there will be more than a million people infected with Ebola by the end of the year.

JOHN LAWS: Okay, so that would mean, on current estimates, about half a million could die?

STEPHEN PARNIS: Clearly. That is not in dispute.

JOHN LAWS: Dear, dear, dear. So you really don't think the Federal Government is doing enough? It sounds like they're sitting on their hands a little bit. I don't know quite what they're waiting for.

STEPHEN PARNIS: Well, we're concerned about that as well. We continue to make the case that we should be treating this with the resourcing and priority that is happening for the other issue that's affecting our security, and that is the crisis in the Middle East.

JOHN LAWS: What are the symptoms?

STEPHEN PARNIS: Of Ebola?

JOHN LAWS: Mm.

STEPHEN PARNIS: Well, initially, it's very hard to differentiate from other infectious illnesses, so if you have a fever, if you are feeling unwell, if your appetite is dropping, if you are starting to get blood in your bowel motions or vomit; these are the sorts of things. But the key question that any doctor asks is: have you been in an area where this disease is? And that is what alerts our excellent public health facilities to contain and control these things.

JOHN LAWS: Okay. Can it be contained?

STEPHEN PARNIS: Yes it can. Yes it can, and I would point to the American experience, where they had a return traveller who's been diagnosed with Ebola. They've got this person in isolation, they are watching contacts, they are giving supportive care. This is the way it should be happening around the world, basically. And if we all did that then this would be controlled. But because it hasn't been, we've got the world's worst Ebola outbreak at the moment.

JOHN LAWS: The world's worst?

STEPHEN PARNIS: This is the worst in history.

JOHN LAWS: Dear, dear, dear. Are we well enough equipped to be able to cope with it, should it arrive on our shores?

STEPHEN PARNIS: Yes.

JOHN LAWS: We are?

STEPHEN PARNIS: No doubt about that. I think we've got among the world's best public health measures in this country and I have, and the AMA has, complete confidence in their resourcing. But, as I said, we want to reduce the risk of this getting around the world anyway, and that's why we should be targeting it at the source.

JOHN LAWS: Yes. I agree, and I think most people would agree. You've been very generous with your time, Stephen, and given us some information that I'm sure is going to be beneficial, for which I thank you greatly.

STEPHEN PARNIS: It's a pleasure, John.

JOHN LAWS: Thank you Stephen, very much indeed.

STEPHEN PARNIS: Okay, all the best.

JOHN LAWS: Bye. Dr Stephen Parnis. Nice man, knows what he's talking about, so listen to what he had to say. He's Australian Medical Association Vice President, Dr Stephen Parnis. But it doesn't sound like a good thing, the help of people like Stephen that we will keep a very vigilant eye upon it, because it is - it's a frightening thing. When you think that about 50 per cent are likely to have died in West Africa; saying 6500 people have been infected and 3000 have died. The figures are not good.

1 October 2014

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